Left Ventricular Performance before and after Removal of the Noncontractile Area of the Left Ventricle and Revascularization of the Myocardium
- 1 May 1972
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 45 (5), 1005-1017
- https://doi.org/10.1161/01.cir.45.5.1005
Abstract
The left ventricular volume and the internal surface areas of noncontractile regions were measured by cineangiocardiography at 60 frames/sec in nine patients with a chronic localized noncontractile area of the left ventricle. Arteriosclerotic heart disease was proven in eight patients by means of coronary arteriography. Left ventricular end-diastolic pressure, stroke volume, ejection fraction, mean circumferential shortening, and cardiac output were also measured before and after removal of the noncontractile area and revascularization of the myocardium. The noncontractile areas, measured at end-diastole, ranged from 12 to 40% of the internal surface area of the left ventricle. Generally, impairment of the left ventricular function depended on the size of the noncontractile areas. The end-diastolic volume was approximately 150 ml/m 2 when the size of noncontractile areas exceeded 20-25% of the left ventricular surface area (r = +0.72; P < 0.05). The ejection fraction decreased as the size of the noncontractile areas increased (r = –0.81; P < 0.01). Following surgery, the left ventricular function, as well as the clinical condition, improved significantly, although the cardiac performance remained in the abnormal range in most patients. The ejection fraction increased ( P < 0.05), and the percent circumferential shortening also improved ( P < 0.05). Removal of the noncontractile area of the left ventricle and revascularization of the myocardium improved the cardiac performance and increased the sense of well being in these patients.Keywords
This publication has 30 references indexed in Scilit:
- Objective evaluation of the effects of direct myocardial revascularization on ventricular function utilizing ergometer exercise testingThe American Journal of Cardiology, 1970
- Left ventricular volume and mass from single-plane cineangiocardiogram. A comparison of anteroposterior and right anterior oblique methodsAmerican Heart Journal, 1970
- Alterations of hemodynamics and myocardial mechanics in patients with congestive heart failure: Pathophysiologic mechanisms and assessment of cardiac function and ventricular contractilityProgress in Cardiovascular Diseases, 1970
- Experimental myocardial infarction. III. Recovery of left ventricular function in the healing phase. Contribution of increased fiber shortening in noninfarcted myocardiumAmerican Heart Journal, 1970
- Implications of left ventricular asynergyThe American Journal of Cardiology, 1969
- Ventricular Aneurysm—Clinical ExperienceThe Annals of Thoracic Surgery, 1968
- Hemodynamic aspects of heart failure∗The American Journal of Cardiology, 1968
- Influence of ventricular size on the relationship between contractile and manifest tensionAmerican Heart Journal, 1965
- Some unanswered questions concerning enlargement and failure of the heart: Grady Reddick memorial lectureAmerican Heart Journal, 1965
- Left Ventricular Volume in Man Measured by Thermodilution*JCI Insight, 1964